Purpose:

This bulletin contains information for home health agencies (HHA) certified to participate in the
Medicare program, regarding the revision of the regulatory requirements including survey
procedures for these providers. Minnesota Department of Health (MDH) Informational Bulletin
00-3 contained information about HCFA Program Memorandum-Transmittal 99-2. Portions of
HCFA Transmittal 99-2 are contained in Transmittal 21 and Program Memorandum-Transmittal
99-2 remains in force and can be accessed at:

http://www.cms.hhs.gov/manuals/pm_trans/99-265.pdf [expired link]

How can I access Transmittal 21?

The Health Care Financing Administration (HCFA) has posted Transmittal 21 on the following
website: http://www.cms.hhs.gov/manuals/pm_trans/R21SOM.pdf [expired link] which includes, "Table of
Contents, Appendix B, Interpretive Guidelines for Home Health Agencies".

What is included in Transmittal 21?

Transmittal 21 includes the following for HHA's:

Appendix B; Interpretive Guidelines for Home Health Agencies, updates current guidance for home health surveys to include instruction for surveying the new Outcome and Assessment Information Set (OASIS) regulations based on recommendations by the State survey agencies, HCFA regional offices, and other interested parties. As part of this update, G-tag 167 has been discontinued. A new tag concerning drug review, G-337, is applicable to all patients serviced by the home health agency. This update also includes regulatory language and guidance that recently amended existing conditions of participation for home health agencies as a result of the July 3, 2000 publication of the final rule for implementation of the prospective payment system for home health agencies. This rule was effective October 1, 2000.

When will these guidelines be implemented?

The effective date of Transmittal 21 is October 1, 2000. The survey interpretive guidelines for HHA's will be implemented as of that date since the changes in the guidelines include some of the information from Transmittal 99-2 as well as changes that are reflected in the PPS regulations for home health agencies. Please refer to Transmittal 21 for pages to delete and insert into the HHA interpretive guidelines.

How can I access the complete HHA Interpretive Guidelines?

Please Note: The CMS Manual System is undergoing a transformation. Please visit this site for more information on the new online manual system, or to download paper copies of existing manuals. CMS Manual System

At the time of this editing the above web site addresses are correct. However CMS web site addresses are subject to change. As MDH becomes aware of these changes we will update the CMS address on this bulletin.

If you have any questions regarding this Information Bulletin, please contact in writing: